“Our results suggest that a higher initiating-dose regimen, with the flexibility of dose schedule adjustment from biweekly to monthly, i.e., once every 3-5 weeks, after the CHR is stabilized with 1 year of ropeg treatment is associated with a high chance of neoplastic cell clearance and robust clinical benefits,” the researchers concluded.
“Despite the CHR rate reaching a plateau, the JAK2V617F VAF or allele burden continued to decline, indicating that the treatment continuously eradicated the neoplastic clones,” the researchers wrote in their report.
The complete molecular remission at 2 years sounds great. But I never read about what doctors say to do then. Can one have a nice long drug vacation with only lab checkups? Or go on to 5 years of Besremi/Peg as used to be the guideline?
Interesting finding; however, not all can tolerate such a high dose of Besremi. It will be interesting to see how the longer term low dose strategy works in comparison.
They report CMR of 25% at two years. This is better than the 6 year Ropeg result of 20.7%, ( <1% being the reference there) but the smaller sample size may be a factor, they don't give a p value. These may be the pts most likely to have durable non-rising MR after year 5.
This is a good reality check that 75-80% of us on IFN (and analogous findings for Rux) will not get to CMR in these time frames, if the trial results carry over. But of course hoping we can do better.
This report follows a pattern I see for all our drugs:
"77.3% of patients achieving CHR by 15 months, 84.1% at 18 months, 81.8% at 21 months, and 75% at 24 months."
So % of pts with CHR start to decline at 18months.
"93.9% of patients ... achieved CHR at least once during 24 months " this also implying that CHR was fleeting for some.
I understand it as CHR for a signif set is not durable. HU and Rux have similar reports. But I'm not sure if we see this on the forum for our various meds.
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The 3 year ProudPV Ropeg trial also used a very high dose at least thru year 1, this plot shows the dosing. Only the titration was slower,
As Hunter says, this dose likely wouldn't work for some pts as we've read here many members here cannot tolerate such doses. I suspect I would not have survived such dosing.
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BESREMi Ropeginterferon alfa-2b is available in Austria and Germany
